Processing blood samples to detect target nucleic acids

ABSTRACT

Provided herein are porous polymer monolith materials and processes that enable integration of blood fractionation, specific nucleic acid amplification and/or detection of nucleic acids from whole blood.

CROSS REFERENCE TO RELATED APPLICATIONS

This application claims priority to U.S. application Ser. No.15/605,099, filed May 25, 2017, which claims the benefit of U.S.Provisional Application Ser. No. 62/341,559 filed on May 25, 2016, eachof which are incorporated herein by reference.

FIELD OF THE TECHNOLOGY

The present disclosure is related to lateral flow porous polymermonoliths for processing blood samples and detecting the presence oftarget nucleic acids as well as the methods of making and using suchmonoliths.

BACKGROUND

Testing of blood samples to detect target nucleic acids can bechallenging. The sensitivity and specificity of nucleic acid-based bloodassays are influenced not only by the abundance of the nucleic acid, butby its availability for amplification and detection. For example, theavailability may be affected if the nucleic acid is sequestered in viralcapsids or if it is associated with bound proteins. More importantly,the components of blood cells have well-known interfering effects onnucleic acid diagnostic techniques, such as inhibition of amplificationand signal detection. A number of solutions have been developed to dealwith this problem.

Most nucleic acid detection systems require a pre-extraction of totalnucleic acids in samples before application to the amplification anddetection system. Some nucleic acid extraction protocols involve lysingall blood cells, binding nucleic acids, and successfully washing awayinhibitory substances. Alternatively, whole blood can be centrifuged toremove red and white blood cells from plasma, separating the cells fromplasma-borne nucleic acids and pathogens. Plasma separation performed inthis manner works well but is not ideal for large numbers of samples andincreases contamination risks due to additional blood handling steps.Simpler methods for pre-processing lysed blood samples for directnucleic acid analysis have been developed. Generally, small amounts ofblood are lysed in reagents that sequester inhibitory substances. Thesespecially-treated blood samples are then used in small amounts inamplification reactions containing specialized buffers andinhibition-tolerant enzymes. However, the enzymes required for thesetechniques are more expensive than standard amplification enzymes.Furthermore, there are stricter limitations on the amount of sample andthe methods that can be used to analyze these preparations, possiblyreducing assay sensitivity.

Given these disadvantages, and the increasing demand for inexpensiveconsumable detection methods particularly in remote diagnostic medicineor at sites with minimally-skilled technical personnel, the need existsfor simple Point-of-Care (POC) tools for the detection of nucleic acidsin blood. Such ideal detection devices for blood should be able toreceive whole blood or minimally diluted whole blood; eliminate orsegregate inhibitory substances away from the amplification anddetection reagents; and operate quickly, inexpensively, and in a fullyintegrated system with minimal requirements for user or instrumentintervention.

SUMMARY

Provided herein are porous polymer monolith materials and processes thatenable integration of blood fractionation, specific nucleic acidamplification and/or detection of nucleic acids from whole blood. Thedisclosed porous polymer monoliths are self-wicking and are amenable tomethods that provide simple target nucleic acid isolation,amplification, and/or detection methods from blood that minimizes oreliminates the need for hazardous chemicals or specialized equipment.

In one aspect, the disclosed porous polymer monoliths are universalnucleic acid detection systems: small homogeneous strips capable ofrapidly separating blood into red-cell-containing and red-cell-freecomponents, absorbing wet amplification and detection reagents designedto detect a single target molecule of interest, and supporting adetection reaction within the monolith. See e.g., FIG. 6. The disclosedpolymer monoliths and related devices not only allow for multiple targetdetection within a single sample (e.g., using target specific multiplexamplification, and multi-modal detection (e.g. multiple fluorescentdyes) within a single reagent zone), but they can be further utilized bygeometrically distributing samples through radial wicking in monolithdiscs or dendritic processes emanating from the sample loading zone. Seee.g., FIGS. 7-10.

The disclosed monoliths are designed to be physically robust whileretaining their critical diagnostic advantages. As such, they can standalone, be molded into a wide variety of shapes, and be integrated intoexisting hardware/consumable systems.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows a view of a monolith for processing a blood sample.

FIG. 2 shows a view of a monolith as it begins to process a blood sample

FIG. 3 shows a view of a monolith as fractionation of a blood samplebegins.

FIG. 4 shows a view of a monolith as the blood-cell-free fraction of theblood sample enters the reagent zone.

FIG. 5 shows a cross sectional view of a sample tube with a blood sampleinto which a monolith has been inserted.

FIG. 6 is a photo of four monoliths configured to amplify and detect atarget nucleic acid, if present.

FIG. 7 shows a top view of a monolith with five reagent zones.

FIG. 8 shows a top view of a disc shaped monolith with four reagentzones.

FIG. 9 shows a top view of a monolith as blood cells are sequestered inthe center of the monolith and as blood-cell-free fluid wicks away fromthe center towards the perimeter of the monolith.

FIG. 10 shows a top view of a monolith as the blood-cell-free fluid hasproceeded to wick to the perimeter of monolith.

FIG. 11 shows a flowchart for a method of fractionating a blood sampleand the amplification and/or detection of a target nucleic acid.

FIG. 12 shows a flowchart for another method of fractionating a bloodsample and the amplification and/or detection of a target nucleic acid.

FIG. 13 shows a flowchart for a method of fractionating a blood sampleand the wicking of a blood-cell-free fraction into a subsequent wickingdevice coupled to a monolith.

FIG. 14 shows a view of a monolith used for testing the tensile strengthof the monolith.

FIG. 15 shows a cross sectional view of a pipette tip configured to makea multilayer porous polymer monolith from a plurality of polymerizablecompositions with different volumetric mass densities.

FIG. 16 shows a view of the components of a mold for the fabrication ofa multilayer porous polymer monolith with a block or slab shape.

DETAILED DESCRIPTION

Provided herein are porous polymer monoliths that enable integration ofblood fractionation, specific nucleic acid amplification, detection ofnucleic acids from whole blood, and self-wicking devices. The disclosedpolymer monoliths can be fabricated by e.g., i) providing a plurality ofmonomers comprising: at least one monomer; and at least one radicallypolymerizable trimethylolpropane (TMP)-based monomer having the formula:

wherein R¹, R², and R³ are each independently selected from—(CH₂CH₂O)_(n)H, —(CH₂CH₂O)_(n)C(O)CH₂CH₂SH, —(CH₂CH₂O)_(n)C(O)CH═CH₂,and —(CH₂CH₂O)_(n)C(O)C(CH₃)═CH₂; and each n is independently an integerfrom 0 to 12, wherein said (TMP)-based monomer is present in an amountranging from 0.1% to 44% (v:v) of the total volume of the plurality ofmonomers; ii) obtaining a polymerizable composition by combining theplurality of monomers in a porogenic solvent; and iii) polymerizing thepolymerizable composition to form the porous polymer monolith.

In one aspect, n in the (TMP)-based monomer described herein each n isindependently an integer from 0 to 6, an integer from 0 to 3, or theinteger 0, 1, 2, or 3. In one aspect, each n is 0.

In one aspect, monoliths of the present methods are self-wicking.

The term “self-wicking” refers to the movement of fluid through amonolith due to the effect of capillary action by the monolith pores ona liquid. This is the property of the monoliths that causes a liquidsample to flow spontaneously from a first portion of a monolith toanother continuous portion without the need for an external pressuredifferential to be applied (pressure is used, for example, inconventional column chromatography). This self-wicking ability may aloneprovide the forces necessary to transport and process a blood sampleduring the methods described herein. Self-wicking is independent of theorientation of the monolith in space and sufficient to overcome theforce of gravity on wicked fluids, resulting in a generally anisotropicflow of wicked fluid within the monolith. As such, the flow of liquidswithin self-wicking monoliths is generally directed by the geometry ofthe monolith. Advantageously, this property may be utilized by wickingfluids through monoliths of defined geometry and aspect ratio so as topredictably direct the flow of fluids. For example, a lateral flowdevice may be developed by applying fluid to a monolith that is suitablylong and thin relative to its width. The monoliths described herein aresuitably self-wicking. For example, in certain aspects, monoliths of thepresent methods comprise a two-minute water wick rate between 1.0 and 10centimeters such as e.g., between 1.5 and 5.0 centimeters. In otherinstances, monoliths of the present methods comprise a two-minute waterwick rate of at least 1.8 cm, at least 2.0 cm, at least 2.3 cm, at least2.5 cm, at least 2.7 cm, at least 3.0 cm, at least 3.2 cm, at least 3.5cm, at least 4.0 cm, at least 4.5 cm, at least 5.0 cm, at least 5.5 cm,at least 6.0 cm, at least 6.5 cm, at least 7.0 cm, or at least 7.5 cm.

In addition to the self-wicking properties, monoliths of the presentmethods are suitable for fractionating biological fluid such as blood.In one aspect, monoliths of the present methods fractionate red bloodcells. Red blood cell (RBC) retention factor (Rf) is a measure analogousto the retardation factor used in planar or thin layer chromatography.For a monolith of constant cross-sectional area, the RBC Rf iscalculated as the ratio of the distance traversed by the farthestobservable RBCs (generally a linear front) to the analogous totaldistance traversed by the blood-cell-free fluid, starting from theproximal edge of the blood loading location. This is visuallyrepresented as a blood-red zone and an adjacent zone that is faintlynude or yellow in color. The RBC Rf is used to measure the relativeability of monoliths to fractionate blood by retarding the movement ofblood cells relative to the other constituents of blood. Here, in oneaspect, the monoliths of the present methods have a measured red bloodcell retention factor (Rf) value in the range of 0.01 to 0.8. In otheraspects, monoliths of the present methods have a measured red blood cellretention factor (Rf) value in the range of 0.01 to 0.8 and comprise atwo-minute water wick rate between 1.5 and 5.0 centimeters.

The pore size of monoliths of the present methods can vary. In oneaspect, the pore size of monoliths of the present methods is within arange of 2-7 microns. In other aspects, monoliths of the present methodshave a measured red blood cell retention factor (Rf) value in the rangeof 0.01 to 0.8 and a pore size within a range of 2-7 microns. In anotheraspect, monoliths of the present methods have a measured red blood cellretention factor (Rf) value in the range of 0.01 to 0.8, comprise atwo-minute water wick rate between 1.5 and 5.0 centimeters, and have apore size within a range of 2-7 microns.

The porosity of monoliths of the present methods can also vary. Incertain instances, the porosity of monoliths of the present methods is50 to 85 percent. In other aspects, monoliths of the present methodshave a measured red blood cell retention factor (Rf) value in the rangeof 0.01 to 0.8 and a porosity of 50 to 85 percent. In another aspect,monoliths of the present methods have a measured red blood cellretention factor (Rf) value in the range of 0.01 to 0.8, comprise atwo-minute water wick rate between 1.5 and 5.0 centimeters, and have aporosity of 50 to 85 percent. In yet another aspect, monoliths of thepresent methods have a measured red blood cell retention factor (Rf)value in the range of 0.01 to 0.8, comprise a two-minute water wick ratebetween 1.5 and 5.0 centimeters, have a pore size within a range of 2-7microns, and have a porosity of 50 to 85 percent.

Monoliths of the present methods can comprise a minimum tensile strengthcorresponding to a supported weight of at least 10 grams. This can bedetermined e.g., by the test protocol described in FIG. 14. Thus, in oneaspect, provided are monoliths having a measured red blood cellretention factor (Rf) value in the range of 0.01 to 0.8 and a minimumweight support of 10 grams. Also provided are monoliths having ameasured red blood cell retention factor (Rf) value in the range of 0.01to 0.8, a porosity of 50 to 85 percent, and a minimum weight support of10 grams. Also provided are monoliths having a measured red blood cellretention factor (Rf) value in the range of 0.01 to 0.8, a two-minutewater wick rate between 1.5 and 5.0 centimeters, a porosity of 50 to 85percent, and a minimum weight support of 10 grams. Further provided aremonoliths having a measured red blood cell retention factor (Rf) valuein the range of 0.01 to 0.8, a two-minute water wick rate between 1.5and 5.0 centimeters, a porosity of 50 to 85 percent, a porosity of 50 to85 percent, and a minimum weight support of 10 grams. In other aspects,monoliths of the present methods can comprise a minimum weight supportcorresponding to a supported weight of at least 50 grams, at least 100grams, at least 250 grams, at least 500 grams, at least 750 grams, atleast 1000 grams, at least 1250 grams, at least 1500 grams or higher.

In certain instances, the at least one TMP-based monomer of thedisclosed methods comprises trimethylolpropane ethoxy triacrylate(TMP(EO)TA). The TMP(EO)TA may be present in an amount ranging from 0.1%to 44% (v:v) based on the total volume of the plurality of monomers.

In certain instances, the at least one TMP-based monomer of thedisclosed methods comprises trimethylolpropanetris(3-mercaptopropionate) (TMPMP). The TMPMP may be present in anamount ranging from 0.1% to 7% (v:v) based on the total volume of theplurality of monomers.

In certain instances, the at least one monomer of the disclosed methodsis selected from ethylene glycol dimethacrylate (EGDMA); 2-hydroxyethylmethacrylate (HEMA); tetra(ethylene glycol) diacrylate (TEGDA);tetra(ethylene glycol) dimethacrylate (TEGDMA); and a combinationthereof including two or more of the EGDMA, HEMA, TEGDA or TEGDMA.

In certain instances, the at least one monomer of the disclosed methodsis selected from ethylene glycol dimethacrylate (EGDMA) in an amountranging from 34% to 75% (v:v) of the total volume of the plurality ofmonomers; 2-hydroxyethyl methacrylate (HEMA) in an amount ranging from10% to 35% (v:v) of the total volume of the plurality of monomers;tetra(ethylene glycol) diacrylate (TEGDA) in an amount ranging from 0%to 15% (v:v) of the total volume of the plurality of monomers; andtetra(ethylene glycol) dimethacrylate (TEGDMA) in an amount ranging from0% to 20% (v:v) of the total volume of the plurality of monomers.

The porogenic solvent of the methods described herein may be alcoholic,i.e., comprises at least one alcohol. In one aspect, the porogenicsolvent comprises a mixture of alcohol and water. In another aspect, theporogenic solvent comprises a mixture of two alcohols. In anotheraspect, the porogenic solvent comprises a mixture of two alcohols andwater. Water may be present in an amount ranging from 0% to 10%.

In one aspect, the porogenic solvent of the methods described hereincomprises a first alcohol of the molecular formula: [C_(X)H_((2X+2))O],wherein X is an integer from 1 to 10. In another aspect, the porogenicsolvent of the methods described herein comprises a first alcohol of themolecular formula: [C_(X)H_((2X+2))O], wherein the first alcohol ispresent in an amount ranging from 0 to 100% of the total volume of theporogenic solvent.

In one aspect, the porogenic solvent of the methods described hereincomprises a second alcohol of the molecular formula:[C_(Y)H_((2Y+2))O₂], wherein Y is an integer from 2 to 10. In anotheraspect, the porogenic solvent of the methods described herein comprisesa second alcohol of the molecular formula: [C_(Y)H_((2Y+2))O₂], whereinthe second alcohol is present in an amount ranging from 0 to 50% of thetotal volume of the porogenic solvent. In one aspect, the alcohols mayinclude the following mixture: methanol from 20% to 65% (v:v), octanolfrom 0% to 60% (v:v) and pentane diol from 0% to 35% (v:v).

In one aspect, the porogenic solvent of the methods described hereinfurther comprises a surfactant. In another aspect, the porogenic solventof the methods described herein further comprises a surfactant selectedfrom sodium dodecyl sulfate (SDS), Poloxamer 124, and Triton X-100. Inanother aspect, the porogenic solvent of the methods described hereinfurther comprises a surfactant selected from SDS present in an amountranging from 0 to 1.0% of the total volume of the porogenic solvent,Poloxamer 124 present in an amount ranging from 0 to 35% of the totalvolume of the porogenic solvent, and Triton X-100 present in an amountranging from 0 to 35% of the total volume of the porogenic solvent.

In one aspect, the polymerizable composition of the methods describedherein has a monomer to solvent ratio of 1:1 to 1:5 (v:v).

As is well known to those skilled in the art, after polymerization of amonolith has been completed, the monolith is washed to remove theremaining solvent and any unincorporated monomers in the monolith andthoroughly dried to prepare the monolith for wicking. Various methodsare known for the washing and drying of monoliths.

Also provided herein are porous polymer monoliths made by any one of themethods described herein and which have one or more of the disclosedproperties, e.g., self-wicking (such as a two-minute water wick ratebetween 1.5 and 5.0 centimeters), an Rf value in the range of 0.01 to0.8, a pore size within a range of 2-7 microns, a porosity of 50 to 85percent, and a minimum weight support of 10 grams.

Also provided herein are methods for detecting a target nucleic acid ina blood-cell-free fraction of a blood sample, comprising: i) providing amonolith fabricated according to the methods described herein, whereinat least one zone of the monolith is designated as a reagent zone; ii)loading at least one amplification and/or detection reagent for a targetnucleic acid into the reagent zone of the monolith; iii) optionallydrying the at least one reagent in the monolith; iv) optionally dilutingthe blood sample in a carrier fluid; v) loading the blood sample at asample application location on the monolith, wherein the monolith issized to absorb the flow of the blood sample along its length or radius,and wherein the flow comprises a) a first fraction of the blood samplecomprising blood cells and blood-cell-free fluid wicking into a firstzone of the monolith; and b) a second fraction of the blood sample freeof blood cells wicking through the first zone of the monolith, into asecond zone of the monolith and into the reagent zone of the monolith;vi) waiting for the blood-cell-free fraction to wick into the reagentzone, wherein the blood-cell-free fraction mixes with the reagent in thereagent zone; vii) optionally mechanically separating the first (bloodcell-containing) zone from the monolith; viii) optionally loading achase fluid at the sample application location or at another location onthe monolith; ix) adjusting the temperature of the mixture in thereagent zone to promote amplification of the target, provided theamplification reagent and target nucleic acid are present in the reagentzone; x) waiting for the amplification of the target nucleic acid and/oramplification of a signal; xii) detecting the presence or absence of anindicator or indicator system in the reagent zone of the monolith,corresponding to the presence or absence of the target nucleic acid; andxiii) optionally mechanically separating the reagent zone from themonolith. In one aspect of the foregoing method, the amplifying isperformed using a polymerase chain reaction (PCR); an isothermal nucleicacid amplification; a signal amplification method; or a nucleic acidamplification and a signal amplification. In one aspect of the foregoingmethod, the target nucleic acid originates from herein the targetnucleic acid originates from bacteria, viruses, fungi, unicellulareukaryotes or other parasitic organisms, or cell(s) originating from thehost organism, including transplanted cells, tumor cells, freecirculating nucleic acids or circulating nucleic-acid-containingbiomolecules.

Also provided are methods for detecting target nucleic acid in ablood-cell-free fraction of a blood sample, comprising: i) providing amonolith fabricated according to the methods described herein; whereinat least one zone of the monolith is designated as a reagent zone; ii)optionally diluting the blood sample in a carrier fluid; iii) loadingthe blood sample at a sample application location on the monolith,wherein the monolith is sized to absorb the flow of the blood samplealong its length or radius, and wherein the flow comprises a) a firstfraction of the blood sample comprising blood cells and blood-cell-freefluid wicking into a first zone of the monolith; and b) a secondfraction of the blood sample free of blood cells wicking through thefirst zone of the monolith, into a second zone of the monolith and notinto the reagent zone of the monolith; iv) waiting for theblood-cell-free fraction to wick into the second zone of the monolith;v) optionally mechanically separating the first zone from the monolith;vi) loading at least one amplification and/or detection reagent for atarget nucleic acid into an initially dry reagent zone of the monolith,wherein the reagent wicks into the second zone of the monolith andwherein the reagent mixes with the blood-cell-free fraction in thesecond zone; vii) optionally loading a chase fluid at the sampleapplication location or at another location on the monolith; viii)adjusting the temperature of the mixture in the second zone to promoteamplification of the target, provided the amplification reagent andtarget nucleic acid are present in the second zone; ix) waiting for theamplification of the target nucleic acid and/or amplification of asignal; and x) detecting the presence or absence of an indicator orindicator system in the monolith, corresponding to the presence orabsence of the target nucleic acid. In one aspect of the foregoingmethod, the amplifying is performed using a polymerase chain reaction(PCR); an isothermal nucleic acid amplification; a signal amplificationmethod; or a nucleic acid amplification and a signal amplification. Inone aspect of the foregoing method, the target nucleic acid originatesfrom bacteria, a virus, a fungus, a unicellular eukaryote or a cell-freenucleic acid.

Also provided are methods for fractioning a blood sample into bloodcells and a blood-cell-free fraction, comprising i) providing a monolithfabricated according to the methods described herein; ii) providing asubsequent wicking device; iii) coupling the subsequent wicking deviceinto fluidic communication to at least one surface of the monolith; iv)optionally diluting the blood sample in a carrier fluid; v) loading theblood sample at a sample application location on the monolith, whereinthe monolith is sized to absorb the flow of the blood sample along itslength or radius, and wherein the flow comprises a) a first fraction ofthe blood sample comprising blood cells and blood-cell-free fluidwicking into the monolith; and b) a second fraction of the blood samplefree of blood cells wicking through the monolith and into the subsequentwicking device; vi) optionally loading a chase fluid at the sampleapplication location or at another location on the monolith; vii)waiting for the blood-cell-free fraction to wick into the subsequentwicking device of the monolith; and viii) optionally uncoupling thewicking device from the monolith. In one aspect of the foregoing method,the wicking device is another polymer monolith or a nitrocellulosestrip.

Also provided herein is a lateral flow porous monolith for thefractionation of a blood sample into blood cells and a blood-cell-freefraction, comprising a porous organic polymer monolith operable withoutthe assistance of fluidic devices, wherein the monolith is sized toabsorb the flow of the blood sample along at least a portion of itslength or radius and the monolith is configured to i) wick the bloodsample into the monolith; ii) sequester the blood cells from the bloodsample in a first zone; iii) wick the blood-cell-free fraction of theblood sample through the first zone and optionally into a second zone ofthe monolith; and iv) have a measured red blood cell retention factor(Rf) value in the range of 0.01 to 0.8. In one aspect of the foregoingmethod, the monolith further comprises a plurality of inorganic beadscoated with an organic porous polymer coating, wherein the inorganicbeads are comprised of silica, metals or metal oxides. In one aspect ofthe foregoing method, the monolith is a self-wicking monolith with a twominute water wick rate between 1.5 and 5.0 centimeters. In one aspect ofthe foregoing method, the monolith has a pore size within a range of 2-7microns. In one aspect of the foregoing method, the monolith has aporosity of 50 to 85 percent. In one aspect of the foregoing method, themonolith is a lateral flow monolith. In one aspect of the foregoingmethod, the monolith comprises a reagent zone configured to receive ablood-cell-free fraction of a blood sample that has wicked through thefirst zone and optionally into a second zone of the monolith. In oneaspect of the foregoing method, the monolith further comprises asubsequent wicking device, wherein the lateral flow device is anotherpolymer monolith or a nitrocellulose strip and wherein the wickingdevice is configured to i) be selectively coupled to the lateral flowporous monolith; ii) be loaded in at least a portion of the wickingdevice with at least one amplification and/or detection reagent for atarget nucleic acid, and iii) receive a blood-cell-free fraction of ablood sample that has wicked through at least the first zone of thelateral flow porous monolith and into the wicking device. In one aspectof the foregoing method, the monolith has a minimum tensile strengthcorresponding to supported weight of 10 grams according to the method ofFIG. 14.

Also provided are methods for fabricating multilayer porous polymermonoliths as described herein in a pipette tip. These methods comprisee.g., i) providing a pipette tip having a conical cavity with an openingat the top, and the narrower end of the pipette is sealed liquid-tight,wherein the wall of the pipette tip is transparent to the passage of UVlight, provided UV light is used to initiate polymerization; ii)dispensing into the pipette tip a first polymerizable compositioncomprising a mixture of a plurality of monomers and a porogenic solvent;iii) dispensing into the pipette tip a second polymerizable compositioncomprising a mixture of a plurality of monomers and a porogenic solvent;iv) optionally providing a source of UV light directed from a pluralityof light sources positioned adjacent to the sides of the pipette tipfrom a plurality of respective directions to provide a uniform source ofUV light directed towards the polymerizable compositions in the pipettetip; and v) initiating polymerization of the polymerizable compositionsin the pipette tip.

In some aspects, polymerization in the aforementioned methods isinitiated through electromagnetic radiation, chemical reaction, viaheat, or combinations thereof. In other aspects of the aforementionedmethod, the volumetric mass density of the first polymerizablecomposition is greater than the volumetric mass density of the secondpolymerizable composition.

Also provided herein are molds for the fabrication of multilayer porousmonoliths as described herein. These methods comprise e.g., i) a moldpart comprising a sheet having first and second sides, configured with ahollow inner cavity with an opening at the upper end for receiving aplurality of polymerizable compositions; and ii) a first and a secondsheet, each having inner and outer flat surfaces, each sheet sized to alength and width to enclose the hollow inner cavity of the mold partwhen the first and second sheets are clamped on opposite sides of themold part, wherein the first and second sheets are transparent to thepassage of UV light, provided UV light is used to initiatepolymerization of the polymerizable compositions.

In some aspects, the inner surfaces of the first and second sheetsdescribed in the aforementioned method comprise non-stick surfaces. Inother aspects, the aforementioned method further comprises a non-sticktransparent layer applied to the inner surfaces of the first and secondsheets. Non-stick transparent layers include, but are not limited to,those that comprise a layer of polyethylene, a layer of polyvinylchloride (PVC), polypropylene, or other polyolefin polymer or a spray onlayer of polytetrafluoroethylene (PTFE).

Other methods of fabricating multilayer porous polymer monoliths in amold comprise i) a mold part comprising a sheet having first and secondsides, configured with a hollow inner cavity with an opening at theupper end for receiving a plurality of polymerizable compositions; ii) afirst and a second sheet, each having inner and outer flat surfaces,each sheet sized to a length and width to enclose the hollow innercavity of the mold part when the first and second sheets are clamped onopposite sides of the mold part, wherein the first and second sheets aretransparent to the passage of UV light, provided UV light is used toinitiate polymerization of the polymerizable compositions; iii)dispensing into the hollow cavity of the mold a first polymerizablecomposition comprising a mixture of a plurality of monomers and aporogenic solvent; iv) dispensing into the hollow cavity of the mold asecond polymerizable composition comprising a mixture of a plurality ofmonomers and a porogenic solvent; v) optionally providing a source of UVlight directed from a plurality of light sources positioned adjacent tothe outer surfaces of the first and second sheets to provide a source ofUV light directed towards the polymerizable compositions in the cavityof the mold; and vi) initiating polymerization of the polymerizablecompositions in the cavity of the mold. In other aspects of theaforementioned method, the volumetric mass density of the firstpolymerizable composition is greater than the volumetric mass density ofthe second polymerizable composition.

In some aspects, polymerization in the aforementioned methods isinitiated through electromagnetic radiation, chemical reaction, viaheat, or combinations thereof.

Other monoliths and processes included in the present disclosure are asdescribed in the Exemplification section below. The contents of allreferences (including literature references, issued patents, publishedpatent applications, and co-pending patent applications) citedthroughout this application are hereby expressly incorporated herein intheir entireties by reference. Unless otherwise defined, all technicaland scientific terms used herein are accorded the meaning commonly knownto one with ordinary skill in the art.

EXEMPLIFICATION

FIG. 1 shows a view of a lateral flow porous polymer monolith 110 forprocessing blood sample 102 as it is applied at sample applicationlocation 112 close to one end of monolith 110. At the opposite end ofmonolith 110, optionally dry reagent 120 is stored in reagent zone 118.Monolith 110 is a porous polymer monolith with self-wicking propertiesand can fractionate a blood sample into blood cells and ablood-cell-free (BCF) fraction. Reagent 120 is at least oneamplification and/or detection reagent to be used to process a BCFfraction after it wicks into reagent zone 118. Reagent 120 will amplifya target nucleic acid in the BCF fraction, if present, and provide anindication if the target nucleic acid is present. Blood sample 102 canoptionally be diluted by am isotonic solution, such as phosphatebuffered saline or other buffers. The volume of blood sample 102 shouldbe selected to correlate with the effective loading volume of aparticular monolith 110 so that the BCF fraction can wick into thereagent zone 118.

Porous polymer monoliths can be formed by mixing monomers and porogenicsolvents to form a polymerizable composition and initiation ofpolymerization, which may be done using heat, UV light, or generation ofradical species by chemical reaction. Monoliths for fractionating bloodcan be characterized by having a highly porous structure, a distributionof certain pore sizes, a wicking rate within a certain range and a redblood cell retention factor (Rf) within a specific range.

FIG. 2 shows a view of monolith 110 of FIG. 1 as it begins to processblood sample 102. Blood sample 102 has entered monolith 110 via sampleapplication location 112 and a portion 114 of blood sample 102 iswicking through monolith 110 in the direction shown by arrow 116.

FIG. 3 shows a view of monolith 110 of FIG. 1 as fractionation of ablood sample 102 is taking place. Blood cells 122 that were in bloodsample 102 are being sequestered in the first zone of monolith 110. Theremaining portion of blood sample 102, i.e., the BCF fraction 124 isbeing wicked further into monolith 110 and towards reagent zone 118.

FIG. 4 shows a view of monolith 110 of FIG. 1 as monolith 110 hasfractionated BCF fluid 124 from the blood sample 102 and the BCFfraction 124 has entered reagent zone 118. Reagent zone 118 has beenloaded with reagent 120 to provide the chemicals needed to performamplification and/or detection of a target nucleic acid. The reagent 120is preferably in a dried form in reagent zone 118. Bloods cells 122 havebeen sequestered in a portion of monolith defining a first zone. Bloodcells 122 have not been damaged or lysed by the action of wickingthrough into monolith 110. The portion of monolith 110 into which BCFfraction 124 has wicked defines a second zone. That second zonecontaining BCF fraction 124 extends into and overlaps with reagent zone118.

BCF fluid 124 mixes with reagent 120 in reagent zone 118 forming amixture 126. If the target nucleic acid is present in the BCF fluid 124then amplification can take place of the target nucleic acid, therebyincreasing the number of copies of the target nucleic acid. Variousamplification methods are known in the field, such as a polymerase chainreaction (PCR) and isothermal amplification that can be used to increasethe number of copies of the target nucleic acid, and thus facilitate thedetection of the target nucleic acid, if present.

Some known amplification methods include loop mediated isothermalamplification process (LAMP), Recombinase/Polymerase Assay (RPA), StrandDisplacement Amplification (SDA), NASBA, Multiple DisplacementAmplification (MDA), Rolling Circle Amplification (RCA), Ligase ChainReaction (LCR), Helicase Dependent Amplification (HDA) and Ramification(RAM). Signal amplification methods are known in the field, such asbranched DNA (bDNA) and Hybrid Capture.

Various detection methods are known in the field, such as quenching ofunincorporated amplification signal reporters (QUASR), quantitativepolymerase chain reaction (qPCR), Nicking Endonuclease SignalAmplification (NESA) and Enzyme-linked Immunosorbent Assay (ELISA).QUASR is described in Ball, C. S. et al, Quenching of UnincorporatedAmplification Signal Reporters in Reverse-Transcription Loop-MediatedIsothermal Amplification Enabling Bright, Single-Step, Closed-Tube, andMultiplexed Detection of RNA Viruses, Analytical Chemistry, 2016, 88,3562-3568, Mar. 16, 2016.

FIG. 5 shows a lateral view of sample tube 504 with blood sample 502into which monolith 510 has been inserted. At the upper end of monolith510 there is a reagent zone 518 containing reagent 520. When the bottomend of monolith 510 is inserted in blood sample 502, then blood sample502 starts wicking up into monolith 510 in the wicking direction shownby arrow 516.

As blood sample 502 wicks into monolith 510, the blood cells in bloodsample 502 will be sequestered in the bottom portion of monolith 510.The BCF fraction of blood sample 502 will continue wicking further upinto monolith 510 and will enter reagent zone 518. If the target nucleicacid is present in the BCF fraction, then amplification of the targetnucleic acid will take place and then the detection of the targetnucleic acid will be evident via an indicator or indication system.

Indication methods can utilize one or more of many known physicalphenomena that comprise molecules that are: light-absorbing,chromogenic, fluorescent (to include provision for fluorescence,time-resolved fluorescence, fluorescence polarization, and/or FörsterResonance Energy Transfer [FRET]), phosphorescent, luminescent,radioactive, or other molecules that absorb and/or emit electromagneticand/or nuclear radiation. Other available indication systems aredependent on electrochemical changes in the reagent zone, such aschanges in conductivity.

FIG. 6 shows a photo 600 of four monoliths 602, 604, 606 and 608. Ablood sample containing a flu virus has been applied to the bottomportion of monoliths 602, 604, and 606. A blood sample without a fluvirus has been applied to the bottom portions of monolith 608 as acontrol. In monoliths 602, 604, 606 and 608 the blood cell portions 622has been sequestered in the lower half of each of the monoliths shown.Wicking of the blood samples has proceeded from the bottom to the top ofeach monolith in the upward direction as shown by arrow 614.

In monoliths 602, 604, 606 and 608, the BCF fraction 624 has continuedto wick into the upper half of the monoliths. Each of the monoliths atthe upper end has a reagent zone for the storage of at least one reagentfor amplification and/or detection of a target nucleic acid. As the BCFfraction of each blood sample enters the reagent zone of each respectivemonolith, then the amplification and detection reagent will process theBCF fraction and provide an indication if the target nucleic acid ispresent. The amplification and detection reagent used was a LAMP QUASRreagent. FIG. 6 shows that monoliths 602, 604 and 606 each received ablood sample which was fractionated and from which the target nucleicacid was amplified. The indicator system in each generated a visuallyobservable indication 602A, 604A and 606A of detection of the targetnucleic acid that originated from a flu virus in this example. The lackof a visible indicator at the upper end 608A of monolith 608 indicatesthat the target nucleic acid was not present in the control monolith608.

The polymerizable composition used to fabricate the self-wicking porouspolymer fractionating monolith in FIG. 6 included the following mix ofmonomers (25% v:v): EGDMA—70%, TEGDA—10%, TMP(EO)TA—10% and HEMA—10%;and the following mix of solvents (75% v:v): 1-Octanol (C₈H₁₀O)—60% andMethanol (CH₄O)—40%.

FIG. 7 shows a top view of monolith 710 configured with a sampleapplication location 712 in its center. Monolith 710 has five reagentzones 718A-718E. FIG. 7 is an embodiment that can process a blood samplethat will wick radially outward from the center of monolith 710. As theblood sample wicks away from the center, the blood cells contained inthe blood sample will be sequestered in the center of monolith 710.Monolith 710 can provide for the detection of target nucleic acids in upto five different target nucleic acids. As the BCF fraction wicks awayfrom the center and towards the perimeter of monolith 710, the BCFfraction will be subdivided into five portions and mixed with therespective five reagents 720A-720E.

FIG. 8 shows a top view of a disc shaped monolith 810 with four reagentzones 818A-818D with respective reagents 820A-820D. Monolith 810provides for the testing of blood sample 814 to detect up to fourdifferent target nucleic acids. Blood sample 814 is applied in thecenter of monolith 810 and the blood sample proceeds to wick from thecenter of monolith 810 towards the perimeter as shown by arrows 816.

FIG. 9 shows a top view of monolith 810 as blood cells 822 aresequestered in the center of monolith 810 and as BCF fluid 824 wicksaway from the center towards the perimeter of monolith 810.

FIG. 10 shows a top view of monolith 810 as the blood cells 822 havebeen sequestered in the center of monolith 810 and the BCF fluid 824 hasproceeded to wick to the perimeter of monolith 810. BCF fluid 824 hasalso entered reagents zones 818A-D where the fluid 824 is able to reactwith up to four different reagents 820A-D and resulting in respectivemixtures 826A-D. If each of the target nucleic acids is present in bloodsample 814, then an indication will become evident in each of thereagent zones.

FIG. 11 shows a flowchart for a method 1100 of fractionating a bloodsample and the detection of a target nucleic acid. This methodcorresponds to the processing of a blood sample as described withrespect to FIGS. 1-10. In block 1102, a monolith is provided for theprocessing of the blood sample. The dimensions of the monolith areselected to be able to absorb, along its length or radius, the volume ofthe blood sample to be applied. In block 1104, at least oneamplification and/or detection reagent for a target nucleic acid isloaded into the reagent zone of the monolith. After step 1104, an optionis to dry the at least one reagent in the monolith.

In block 1106, the blood sample to be tested is loaded into the monolithat the sample application location. Prior to loading the blood sample,an option is to dilute the blood sample with an appropriate carrierfluid, such as phosphate buffered saline. The fractions of the bloodsample comprising blood cells and BCF fluid may wick into a first zoneof the monolith and a first fraction comprising blood cells may besequestered in the first zone; and a second fraction of the blood samplefree of blood cells comprising BCF fluid may wick through the first zoneof the monolith, into a second zone of the monolith, and into thereagent zone of the monolith.

In block 1108, a certain amount of time will elapse while waiting forthe BCF fraction to wick into the reagent zone, the BCF fraction mixingwith the reagent in the reagent zone. The amount of time will depend onmany factors, including the size and shape of the monolith, the volumeof the blood sample applied to the monolith, and the wicking ratethrough the monolith. This waiting time can be determined for aparticular fractionating monolith prior to use. In other words, thewaiting time is pre-determined as in waiting a predetermined timeperiod. An option after step 1108 is to mechanically separate the first(blood cell-containing) zone from the monolith. Another option is toload a chase fluid at the sample application location or at anotherlocation on the monolith, to help wick the blood sample through themonolith.

In block 1110, depending on the type of amplification method that isused, the temperature of the mixture in the reagent zone is adjusted topromote amplification of the target if the amplification reagent andtarget nucleic acid are present in the reagent zone. If, for example, anisothermal amplification method is being used, the temperature in thereagent zone must be raised above room temperature. If a PCR method isbeing used, then a certain amount of thermal cycling must take place.

Elevated temperatures required for nucleic acid amplification willgenerally result in cell lysis or viral particle lysis. Therefore, it isimportant that bulk fluid flow has completed or is near completionbefore heat-induced cell or particle lysis. Because lysed red cellscontribute the majority of amplification and detection inhibitors, it isimportant that the red cells or their lysis products are sufficientlydistant so that the diffusion of inhibitors from these cells into thedetection zone is minimal during the time course of the test. Bycontrast, the lysis of non-blood cells or particles (e.g. bacteria,viruses) at or near the reagent zone may be advantageous if theirnucleic acids are targets for amplification and/or detection.

In step 1112, a certain amount of time will elapse while waiting for theamplification of a target nucleic acid to take place if the target ispresent in the mixture in the reagent zone. If the target is notpresent, then the waiting must have an upper limit on how long to waitbefore seeing or sensing in the subsequent detecting step 1114 that thetarget is not detected. This time period will depend on many factors,but can be determined for a particular fractionating monolith andapplication.

In step 1114, the detection, i.e., the presence or absence of anindicator or indication system in the reagent zone of the monolith, canbe determined by visual, optical or other indicative methods,corresponding to the presence or absence of the target nucleic acid inthe blood sample. An option after step 1114 is to mechanically separatethe reagent zone from the monolith.

FIG. 12 shows a flowchart for a method 1200 of fractionating a bloodsample and the detection of a target nucleic acid. In step 1202, amonolith is provided for the processing of the blood sample. Thedimensions of the monolith are selected to be able to absorb, along itslength or radius, the volume of the blood sample to be applied. In step1204, the blood sample to be tested is loaded into the monolith at thesample application position. The blood sample comprising blood cells andBCF fluid may wick into a first zone of the monolith and the blood cellswill be sequestered in the first zone. A second fraction of the bloodsample free of blood cells comprising BCF fluid may wick through thefirst zone of the monolith, into a second zone of the monolith and notinto the reagent zone of the monolith. As a result, the reagent zone ofthe monolith remains dry during this step. Prior to loading the bloodsample, an option is to dilute the blood sample with an appropriatecarrier fluid, such as phosphate buffered saline or other buffers.

In step 1206, a certain amount of time will elapse while waiting for theBCF fraction to wick into the second zone of the monolith. The amount oftime will depend on many factors, including the size and shape of themonolith, the volume of the blood sample applied to the monolith, andthe wicking rate through the monolith. This waiting time can bedetermined for a particular fractionating monolith prior to use. Anoption after step 1206 is to mechanically separate the first (bloodcell-containing) zone from the monolith.

In step 1208, at least one amplification and/or detection reagent for atarget nucleic acid is loaded into an initially dry reagent zone of themonolith; the reagent wicks through the reagent zone and into the secondzone of the monolith; the reagent mixing with the BCF fraction in thesecond zone. After step 1208, an option is to load a chase fluid at thesample application location or at another location on the monolith, tohelp wick the blood sample through the monolith.

In step 1210, depending on the type of amplification method that isused, the temperature of the mixture in the second zone is adjusted topromote amplification of the target if the amplification reagent andtarget nucleic acid are present in the second zone. If, for example, anisothermal amplification method is being used, the temperature in thereagent zone must be raised above room temperature. If a PCR method isbeing used, then a certain amount of thermal cycling must take place.

In step 1212, a certain amount of time will elapse while waiting for theamplification of a target nucleic acid to take place if the target ispresent in the mixture in the reagent zone. If the target is notpresent, then the waiting time must have an upper limit as to how longto wait before seeing or sensing in the subsequent detecting step 1214that the target is not detected. This time period will depend on manyfactors, but can be determined for a particular fractionating monolithand application.

In step 1214, the detection, i.e. the presence or absence of anindicator or indication system in the reagent and/or second zones of themonolith, can be determined by visual, optical or other indicativemethods, corresponding to the presence or absence of the target nucleicacid in the blood sample.

FIG. 13 shows a flowchart for a method 1300 of fractionating a bloodsample into blood cells and a BCF fraction. In step 1302, afractionating monolith is provided for the processing of the bloodsample. In step 1304, a subsequent wicking device is provided. In step1306, the wicking device is coupled into fluidic communication with atleast one surface of the monolith.

In step 1308, the blood sample to be tested is loaded at the sampleapplication position into the monolith. The blood sample comprisingblood cells and BCF fluid may wick into the monolith and a firstfraction of the blood sample comprising blood cells will be sequesteredin the monolith. A second fraction of the blood sample free of bloodcells comprising BCF fluid may wick through the monolith and into thesubsequent wicking device. Prior to loading the blood sample, an optionis to dilute the blood sample with an appropriate carrier fluid, such asphosphate buffered saline or other buffers.

In step 1310, a certain amount of time will elapse while waiting for theBCF fraction to wick into the wicking device. The amount of time willdepend on many factors, including the size and shape of the monolith,the size and shape of the wicking device, the volume of the blood sampleapplied to the monolith, the wicking rate through the monolith, and thewicking rate in the wicking device. This waiting time can be determinedfor a particular combination of fractionating monolith and wickingdevice prior to use. An option after step 1310 is to uncouple thewicking device from the monolith.

FIG. 14 shows a view of a monolith 1400 with a length 1402 and a width1404 at the widest portions used for testing the tensile strength ofvarious formulations of a fractionating monolith. A fractionatingmonolith must have some minimum tensile strength in order to bemanufactured, transported and used for fractionating. A standardizedtensile test, similar to a test such as the ASTM E8 (or ASTM D638)tensile test was developed. Monolith 1400 was fabricated with a “dogbone” shape, being narrower at the center 1406 than at the upper end1410 and lower end 1412. After fabrication using a particular formula ofmonomers and solvents, after any remaining solvent had been washed outand the monolith had been dried and stored at room temperature for atime period, the monolith was ready to be tested. The particularstandardized dimensions of a monolith under test was 6.35 mm in length,19.05 mm at the two ends, 12.7 mm at the center and 1.0 mm+/−0.1 mm inthickness. The upper end of a monolith 1400 under test was clamped atthe top end 1410 and a series of increasing weights, starting at 10grams were attached and increasing amounts of weight were added untilthe monolith under test was pulled apart in the narrower section of themonolith. It was determined that a fractionating monolith had to have aminimum strength of 10 grams in this test in order to be durable enoughto undergo the expected handling conditions prior to and during a testfor a target.

Fractionating lateral flow monoliths can be formed by mixing togethermonomers and porogenic solvents to form a polymerizable composition byproviding a mixture of monomers, such as at least one monomer and atleast one radically polymerizable trimethylolpropane (TMP)-based monomerhaving the formula:

wherein R¹, R², and R³ are each independently selected from—(CH₂CH₂O)_(n)H, —CH₂CH₂O)_(n)C(O)CH₂CH₂SH, —(CH₂CH₂O)_(n)C(O)CH═CH₂,and —(CH₂CH₂O)_(n)C(O)C(CH₃)═CH₂; and each n is independently an integerfrom 0 to 12, wherein said (TMP)-based monomer is present in an amountranging from 0.1% to 44% (v:v) of the total volume of the plurality ofmonomers. One version of the TMP-based monomer is when n=3. One versionof a TMP-based monomer is TMP(EO)TA (trimethylolpropane ethoxytriacrylate) from 0.1% to 44%. TMP(EO)TA as one monomer in a mixtureused to make a fractionating porous polymer monolith can increase thestrength of such a monolith. TMPMP (trimethylolpropanetris(3-mercaptopropionate)) from 0% to 7% (v:v) is another example of amonomer in a mixture used to make a fractionating porous polymermonolith which can increase the flexibility of such a monolith. Othermonomers for making fractionating monoliths include: EGDMA (ethyleneglycol dimethacrylate) from 34% to 75% (v:v), HEMA (2-hydroxyethylmethacrylate) from 10% to 35% (v:v), TEGDA (tetra(ethylene glycol)diacrylate) from 0% to 15% (v:v) and TEGDMA (tetra(ethylene glycol)dimethacrylate) from 0% to 20% (v:v).

A lateral flow porous monolith for the fractionation of a blood sampleinto blood cells and a BCF fraction may include a porous organic andoptionally inorganic polymer monolith operable without the assistance offluidic devices. Such a monolith may be sized to absorb the flow of theblood sample along at least a portion of its length or radius. Afractionating monolith may be configured to: load the blood sample intothe monolith; wick the blood sample into the monolith; sequester theblood cells from the blood sample in a first zone; wick the BCF fractionof the blood sample through the first zone and optionally into a secondzone of the monolith; and have a measured red blood cell retentionfactor (Rf) value in the range of 0.01 to 0.8.

A fractionating monolith can include inorganic beads coated with anorganic porous polymer coating, wherein the inorganic beads arecomprised of silica, metals, and/or metal oxides. The polymer coatingcan be the same or similar to the polymer in the rest of the monolith.

The wicking test measures the distance water will travel verticallythrough a monolith cured with dimensions: 1.27 cm wide, 6.35 cm long,0.30 cm thickness. The monolith is prepared as described herein.

Prior to testing, the monolith was stored in atmospheric conditions(temperature: 18-22° C., RH 10-40%), although the inventors have foundthat no environmental control is required for monoliths that have notbeen loaded with environmentally-sensitive reagents (for example,through immobilization/covalent grafting). The measurement may be madevisually, by observing the solvent front.

-   -   1. 3 mm of the monolith is submerged in de-ionized water with        the monolith in the upright orientation;    -   2. The water moves vertically up the length of the monolith due        to wicking action;    -   3. The distance traveled by the water over the course of 2.0        minutes is measured at the corner of the monolith having the        greatest measurement.

A dye may be added to aid measurement. Suitably the dye is a dye thattravels with the water without being significantly retarded by themonolith. Suitable examples include FD&C Yellow number 1 andfluorescein. Red 40 and Blue 1 may be also be used for some monoliths asdescribed herein.

The blood-cell-free (herein BCF) zone does not contain any visible redblood cells (erythrocytes) or native white blood cells (leukocytes), butmay contain prokaryotic cells, unicellular eukaryotic cells, fungalcells or cell aggregates, or viral particles. The zone may contain cellderivatives such as platelets, exosomes, membrane fragments, and/orbiomolecules such as nucleic acids, proteins, peptides, carbohydratesand lipids.

FIG. 15 illustrates a cross sectional view of a pipette tip 1500configured to make a multilayer porous polymer monolith 1510 from aplurality of polymerizable compositions having different volumetric massdensities. Here, the pipette tip 1500 has a conical cavity with anopening at the top. The narrow end of the pipette tip is sealedliquid-tight. The wall of the pipette tip is transparent to the passageof UV light, if UV light is used to initiate polymerization.

A plurality of polymerizable compositions 1502 may be dispensedsequentially into the conical cavity of pipette tip 1500. A firstpolymerizable composition comprising a mixture of a plurality ofmonomers and a porogenic solvent is dispensed into pipette tip 1500forming a first layer 1504. A second polymerizable compositioncomprising a mixture of a plurality of monomers and a porogenic solventis dispensed into pipette tip 1500 forming a second layer 1506. To formlayers within monolith 1510, the first composition will have a highervolumetric mass density than the second composition to minimize themixing of the two compositions.

Initiation of polymerization can be performed using electromagneticradiation, such as UV light, heating, chemical reaction or combinationsthereof. If initiation of polymerization is by UV light, multiple UVlight sources 1508 can be positioned around pipette tip 1500 with the UVlight directed towards the polymerizable compositions in layers 1504 and1506 to initiate polymerization of the compositions to form a multilayermonolith 1510 within pipette tip 1500.

FIG. 16 shows a view of the components of a mold 1600 for thefabrication of a multilayer porous polymer monolith with a block or slabshape. A first flat sheet 1602 and a second flat sheet 1604 enclose aninner mold part 1606 when clamped together to form a mold for making amultilayer monolith. Each sheet 1602 and 1604 has inner and outer flatsurfaces. Each sheet 1602 and 1604 is sized to a length and width toenclose the hollow inner cavity 1610 of mold part 1606 when the firstsheet 1602 and the second sheet 1604 are clamped on opposite sides ofinner mold part 1606. The first sheet 1602 and second sheet 1604 aresuitably transparent to the passage of UV light, if UV light is used toinitiate polymerization. Initiation of polymerization can be performedusing electromagnetic radiation, such as UV light, heating, chemicalreaction or combinations thereof.

Mold part 1606 has a hollow inner cavity 1610 with an opening 1608 atthe upper end for receiving a sequence of polymerizable compositionswhen the components of mold 1600 are clamped together. A firstpolymerizable composition comprising a mixture of a plurality ofmonomers and a porogenic solvent is dispensed into assembled mold 1600forming a first layer at the bottom of mold cavity 1610. A secondpolymerizable composition comprising a mixture of a plurality ofmonomers and a porogenic solvent is dispensed into assembled mold 1600forming a second layer positioned on top of the first layer. To formhorizontal layers within a monolith in assembled mold 1600, the firstcomposition will have a higher volumetric mass density than the secondcomposition to minimize the mixing of the two compositions.

If UV light is used to initiate polymerization of the polymerizablecompositions in cavity 1610 of the assembled mold 1600, at least two UVlight sources may be positioned adjacent to the outer surfaces of thefirst sheet 1602 and second sheet 1604 to provide a source of UV lightdirected towards the polymerizable compositions in the cavity 1610 ofthe assembled mold 1600. After polymerization is complete, a multilayermonolith will have been formed in assembled mold 1600. Mold 1600 can bedisassembled by unclamping mold 1600, then the first sheet 1602 and thesecond sheet 1604 can be removed from inner mold part 1606 and amultilayer monolith can be removed from inner mold part 1606.

To facilitate disassembly, sheets 1602 and 1604 can be made of materialswith non-stick surfaces, such as various plastics or borosilicate glassthat will not stick to a fabricated monolith. In another embodiment, tofacilitate the disassembly of mold 1600, the inner surfaces of sheets1602 and 1604 may be coated or covered with a non-stick layer. Thenon-stick layer may be a layer of polyethylene, a layer of PVC,polypropylene, or other polyolefin polymer or other plastic. Thenon-stick layer may also be a spray on coating of PTFE or other suitablemold release coating.

It is to be understood that the examples and modifications describedherein are for illustrative purposes only and that various modificationsor changes in light thereof will be suggested to persons skilled in theart and are to be included within the spirit of this application and thescope of the appended claims.

The invention claimed is:
 1. A lateral flow porous monolith for thefractionation of a blood sample into blood cells and a blood-cell-freefraction, comprising: a porous organic polymer monolith obtained byproviding a plurality of monomers comprising: at least one monomer; andat least one radically polymerizable trimethylolpropane (TMP)-basedmonomer having the formula:

wherein R¹, R², and R³ are each independently selected from—(CH₂CH₂O)_(n)H, —(CH₂CH₂O)_(n)C(O)CH₂CH₂SH, —(CH₂CH₂O)_(n)C(O)CH═CH₂,and —(CH₂CH₂O)_(n)C(O)C(CH₃)═CH₂; and each n is independently an integerfrom 0 to 12: and wherein the at least one TMP-based monomer comprisestrimethylolpropane tris(3-mercaptopropionate) (TMPMP) in an amountranging from 0.1% to 7% (v:v) of the total volume of the plurality ofmonomers obtaining a polymerizable composition by combining theplurality of monomers in a porogenic solvent; and polymerizing thepolymerizable composition to form the porous organic polymer monolith;wherein the porous organic polymer monolith is operable without theassistance of fluidic devices, wherein the monolith is sized to absorbthe flow of the blood sample along at least a portion of its length orradius and the monolith is configured to: wick the blood sample into themonolith; sequester the blood cells from the blood sample in a firstzone; wick the blood-cell-free fraction of the blood sample through thefirst zone; and have a measured red blood cell retention factor (Rf)value in the range of 0.01 to 0.8.
 2. The monolith of claim 1, furthercomprising a plurality of inorganic beads coated with an organic porouspolymer coating, wherein the inorganic beads are comprised of silica,metals or metal oxides.
 3. The monolith of claim 1, wherein the monolithis a self-wicking monolith with a two minute water wick rate between 1.5and 5.0 centimeters.
 4. The monolith of claim 1, wherein the monolithhas a pore size within a range of 2-7 microns.
 5. The monolith of claim1, wherein the monolith has a porosity of 50 to 85 percent.
 6. Themonolith of claim 1, wherein the monolith comprises a reagent zoneconfigured to receive a blood-cell-free fraction of a blood sample thathas wicked through the first zone of the monolith.
 7. The monolith ofclaim 1, further comprising a subsequent wicking device, wherein thelateral flow device is another polymer monolith or a nitrocellulosestrip and wherein the wicking device is configured to: be selectivelycoupled to the lateral flow porous monolith; be loaded in at least aportion of the wicking device with at least one amplification and/ordetection reagent for a target nucleic acid, and receive ablood-cell-free fraction of a blood sample that has wicked through atleast the first zone of the lateral flow porous monolith and into thewicking device.
 8. The organic porous monolith of claim 1, wherein themonolith has a minimum tensile strength corresponding to a supportedweight of at least 10 grams.
 9. The organic porous monolith of claim 1,wherein n is
 0. 10. The organic porous monolith of claim 1, wherein theat least one monomer comprises trimethylolpropane ethoxy triacrylate(TMP(EO)TA) in an amount ranging from 0.1% to 44% (v:v) of the totalvolume of the plurality of monomers.
 11. The organic porous monolith ofclaim 1, wherein the at least one monomer is selected from ethyleneglycol dimethacrylate (EGDMA); 2-hydroxyethyl methacrylate (HEMA);tetra(ethylene glycol) diacrylate (TEGDA); tetra(ethylene glycol)dimethacrylate (TEGDMA); and a combination thereof including two or moreof the EGDMA, HEMA, TEGDA or TEGDMA.
 12. The organic porous monolith ofclaim 1, wherein the at least one monomer is selected from ethyleneglycol dimethacrylate (EGDMA) in an amount ranging from 34% to 75% (v:v)of the total volume of the plurality of monomers; 2-hydroxyethylmethacrylate (HEMA) in an amount ranging from 10% to 35% (v:v) of thetotal volume of the plurality of monomers; tetra(ethylene glycol)diacrylate (TEGDA) in an amount ranging from 0% to 15% (v:v) of thetotal volume of the plurality of monomers; and tetra(ethylene glycol)dimethacrylate (TEGDMA) in an amount ranging from 0% to 20% (v:v) of thetotal volume of the plurality of monomers.
 13. The organic porousmonolith of claim 1, wherein the porogenic solvent comprises at leastone of the following alcohols; a mixture of alcohols and water; a firstalcohol of the formula: [C_(X)H_((2X+2))O], wherein X is an integer from1 to 10; and a second alcohol of the formula: [C_(Y)H_((2Y+2))O₂],wherein Y is an integer from 2 to
 10. 14. The organic porous monolith ofclaim 13, wherein the porogenic solvent further comprises at least oneof the following: a surfactant; sodium dodecyl sulfate (SDS),polyethylene-polypropylene glycol, and polyethylene glycoltert-octylphenyl ether.
 15. The organic porous monolith of claim 11,wherein the porogenic solvent comprises at least one of the followingalcohols; a mixture of alcohols and water; a first alcohol of theformula: [C_(X)H_((2X+2))O], wherein X is an integer from 1 to 10; and asecond alcohol of the formula: [C_(Y)H_((2Y+2))O₂], wherein Y is aninteger from 2 to 10.